Viruses Associated with Gastroenteritis

A special issue of Viruses (ISSN 1999-4915). This special issue belongs to the section "Human Virology and Viral Diseases".

Deadline for manuscript submissions: 31 October 2025 | Viewed by 2138

Special Issue Editors


E-Mail Website
Guest Editor
Institute of Hygiene and Tropical Medicine, NOVA University, Lisbon, Portugal
Interests: rotavirus; hepatitis D virus; hepatitis B virus; virus–host interactions

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Guest Editor
Interdisciplinary Center for Research in Animal Health (CIISA), Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
Interests: rotavirus; norovirus; viruses causing gastroenteritis; African swine fever virus; vaccine development; molecular epidemiology

Special Issue Information

Dear Colleagues,

It is estimated that 50-70% of all cases of infectious acute gastroenteritis (AGE) worldwide are caused by viruses. Noroviruses, rotaviruses, adenoviruses and astroviruses are the main causative agents, accounting for 3-5 billion cases and 1.5 million deaths per year; these particularly affect children in low and middle-income countries (LMIC) with poor access to safe water, sanitation and health care infrastructure.

Prevention and vaccination remain the sole means of reducing the incidence of this disease. As of today, the only approved vaccines target rotaviruses, and these are included in infant vaccination plans in many countries, contributing to a reduction in the number of new infections and cases of severe diarrhea. However, these vaccines seem to show reduced efficacy in LMICs. Several factors might contribute to this phenomenon, including host genetic factors (e.g., histo-blood group antigens (HBGAs)), the gut microbiota and environmental enteropathy. Several vaccine candidates that target noroviruses are also being tested in clinical trials at different stages.

Rotaviruses, noroviruses and astroviruses have RNA genomes with significantly higher rates of mutation when compared to DNA viruses, including adenoviruses. Therefore, the implementation of monitoring plans that aim to control circulating strains and variants is crucial to ensuring the accuracy of laboratory diagnosis.

This Special Issue will focus on the mechanisms implicated in the pathogenesis of viruses associated with acute gastroenteritis, with an emphasis on their pathophysiology, virus tropism and replication, vaccine design and production, preventive measures, the development of new therapeutic approaches, the immune response, differential laboratory diagnosis, the role of the microbiota, host genetic factors, molecular epidemiology, and surveillance.

Dr. Celso Cunha
Dr. Claudia Istrate
Guest Editors

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Keywords

  • vaccines
  • therapeutic approaches
  • virus replication
  • molecular epidemiology
  • immune response
  • microbiome
  • diagnosis

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Published Papers (4 papers)

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Research

19 pages, 3132 KiB  
Article
Molecular Epidemiology of Human Adenovirus from Acute Gastroenteritis Cases in Brazil After the COVID-19 Pandemic Period, 2021–2023
by Mateus de Souza Mello, Fábio Correia Malta, Alexandre Madi Fialho, Fernanda Marcicano Burlandy and Tulio Machado Fumian
Viruses 2025, 17(4), 577; https://doi.org/10.3390/v17040577 - 17 Apr 2025
Viewed by 374
Abstract
Human enteric adenoviruses (HAdV-F40/41) play a crucial role as causative agents of acute gastroenteritis (AGE), particularly affecting children in low-and middle-income countries. This study investigated the prevalence, genetic diversity, and molecular characteristics of HAdV-F40/41 in AGE cases reported in Brazil from 2021 to [...] Read more.
Human enteric adenoviruses (HAdV-F40/41) play a crucial role as causative agents of acute gastroenteritis (AGE), particularly affecting children in low-and middle-income countries. This study investigated the prevalence, genetic diversity, and molecular characteristics of HAdV-F40/41 in AGE cases reported in Brazil from 2021 to 2023, a period after the COVID-19 pandemic. A total of 1980 stool samples collected from medically attended AGE patients from nine states were analyzed by TaqMan-based qPCR. Overall, HAdV was detected in 16.6% (n = 328/1980) of cases, with the highest prevalence observed in children under five years of age. The positive HAdV samples were genotyped through partial sequencing of the hexon and/or fiber genes followed by phylogenetic analysis. Enteric HAdVs (HAdV-F40/41) were detected in 3.2% (n = 63/1980) of samples, with HAdV-F41 (44.1%) being the most common genotype. Among the non-enteric types, HAdV-C (29.4%) was the most prevalent, followed by HAdV-B (13.2%), HAdV-A (10.3%), and HAdV-D (2.9%). Phylogenetic analysis of the hexon (HVR1–HVR6) and fiber (Shaft) gene regions identified two major clusters, H-GTC1 and F-GTC2, showing close genetic relationships with global strains. HAdV-F40/41 demonstrated significantly higher viral loads compared to non-enteric HAdVs. These findings highlight the importance of continued surveillance of HAdV-F to better understand its role in AGE cases and support public health strategies, including potential vaccine development. Full article
(This article belongs to the Special Issue Viruses Associated with Gastroenteritis)
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16 pages, 2720 KiB  
Article
Concurrent Circulation of Viral Agents in Pediatric Patients Presenting with Respiratory Illness and Diarrheal Symptoms in Metropolitan Region of São Paulo, Brazil, 2021
by Adriana Luchs, Natanael Sutikno Adiwardana, Leonardo Cecilio da Rocha, Ellen Viana, Simone Guadagnucci, Adriana Parise, Vanessa Cristina Martins Silva, Lais Sampaio de Azevedo, Raquel Guiducci, Yasmin França, Natacha Luana Pezzuol Frank, Ana Lucia Nascimento da Silva, Andre Luiz Vianna de Oliveira, André Henrique Souza Azevedo, Bárbara Segatelli Carreteiro and Maurício Lacerda Nogueira
Viruses 2025, 17(4), 497; https://doi.org/10.3390/v17040497 - 29 Mar 2025
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Abstract
Pneumonia and diarrhea are the leading causes of death in children under 5 globally, worsened by viral infections. This study investigates viral agents in children ≤ 3 years with respiratory illness and diarrhea in Metropolitan Region of São Paulo, Brazil, during spring 2021. [...] Read more.
Pneumonia and diarrhea are the leading causes of death in children under 5 globally, worsened by viral infections. This study investigates viral agents in children ≤ 3 years with respiratory illness and diarrhea in Metropolitan Region of São Paulo, Brazil, during spring 2021. Twenty paired samples (oropharyngeal swab and feces) were tested using in-house qPCR for HBoV and HAdV, RT-qPCR for RVA, EV, PeV-A, and NoV, and a commercial RT-qPCR kit for SARS-CoV-2, Flu A/B, and RSV. HAstV was detected with conventional nested (RT)-PCR. Positive samples were sequenced for molecular characterization and phylogenetic analysis. Seven viruses were identified: HBoV, NoV, HAdV, PeV-A, EV, RSV, and Flu A. HBoV and NoV were detected in 75% of cases, with co-infection in 65% of patients, indicating their involvement in the gastro-respiratory illness. Genotyping of HBoV (HBoV-1), NoV (GII.4_Sydney[P16], GII.2[P16], and GII.4_Sydney[P31]), EV (Coxsackievirus A6), HAdV (species C, type 6), and PeV-A (genotype 1) showed local virus diversity. Phylogenetic analysis indicated no ongoing community outbreak, with distinct clusters observed. The findings highlight the overlap of respiratory and enteric diseases, revealing local viral diversity and high exposure to enteric viruses. This underscores the challenges in differential diagnosis and the need for syndromic surveillance. Full article
(This article belongs to the Special Issue Viruses Associated with Gastroenteritis)
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11 pages, 1450 KiB  
Article
Epidemiological and Genetic Characteristics of Sapovirus in Shandong, China, 2022–2023
by Mingxin Guo, Meijia Li, Ti Liu, Wenkui Sun, Kaige Du, Shuopeng Yang, Zhongyan Fu and Zengqiang Kou
Viruses 2025, 17(4), 469; https://doi.org/10.3390/v17040469 - 26 Mar 2025
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Abstract
Sapovirus (SaV) is a major pathogen responsible for acute gastroenteritis (AGE), and its incidence has been increasing in recent years. This study investigates the prevalence and the genetic characteristics of SaV in Shandong Province during 2022–2023, based on a surveillance network covering all [...] Read more.
Sapovirus (SaV) is a major pathogen responsible for acute gastroenteritis (AGE), and its incidence has been increasing in recent years. This study investigates the prevalence and the genetic characteristics of SaV in Shandong Province during 2022–2023, based on a surveillance network covering all age groups. Samples were obtained from a viral diarrhea surveillance network in Shandong Province during 2022–2023. SaVs were identified through quantitative reverse-transcription polymerase chain reaction (RT-qPCR). PCR amplification and Sanger sequencing were performed on positive samples, and whole-genome sequencing was conducted using metagenomic sequencing technology. Sequence analysis was conducted using BioEdit 7.0.9.0 and MEGA X, while statistical analysis was performed with SPSS 26.0. A total of 157 SaV-positive cases were identified, resulting in a positivity rate of 1.12%. The positivity rate for SaV was 0.75% in 2022 and it increased significantly to 1.42% in 2023. The highest positivity rates for both 2022 and 2023 were observed in November. The highest positivity rate was observed in the 3–5-year-old age group. In 2022, Dongying City had the highest positivity rate, while Zaozhuang City exhibited the highest rate in 2023. The incidence of vomiting in SaV-positive patients was significantly higher compared to SaV-negative patients (P = 0.002). Eight genotypes were identified in both the VP1 and RdRp regions. The complete genome sequence analysis of a GI.3 strain showed that NS1 (5.88%, 4/68) was the region most prone to amino acid variation, followed by VP2 (5.45%, 9/165) within the same genotype. SaV infections are more prevalent in cold weather, with young children being particularly susceptible. The SaV positivity rate in 2023 increased significantly accompanied by an increased diversity of genotypes, compared to that of 2022. The NS1 region exhibits the biggest variation within the same genotype, indicating that more attention should be paid to other regions besides VP1 in the future study. Ongoing surveillance of SaV is recommended for effective prevention and control. Full article
(This article belongs to the Special Issue Viruses Associated with Gastroenteritis)
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12 pages, 1230 KiB  
Article
Significant Association Between Increased Abundance of Selected Bacterial Lipopolysaccharides and Norovirus Diarrhea Among South African Infants
by Lerato P. Kgosana, Mapaseka L. Seheri and Cliff A. Magwira
Viruses 2025, 17(2), 278; https://doi.org/10.3390/v17020278 - 17 Feb 2025
Viewed by 772
Abstract
Bacterial lipopolysaccharides (LPS) have been shown to promote enteric viral infections. This study assessed whether possessing elevated levels of LPS was associated with norovirus infection. Fecal samples from diarrheic norovirus-positive (DNP) (n = 26), non-diarrheal norovirus-negative (NDNN) (n = 26), asymptomatic norovirus-positive (ANP) [...] Read more.
Bacterial lipopolysaccharides (LPS) have been shown to promote enteric viral infections. This study assessed whether possessing elevated levels of LPS was associated with norovirus infection. Fecal samples from diarrheic norovirus-positive (DNP) (n = 26), non-diarrheal norovirus-negative (NDNN) (n = 26), asymptomatic norovirus-positive (ANP) (n = 15), and diarrheic norovirus-negative (DNN) (n =15) infants were assayed for selected bacterial LPS by quantitative PCR. The mean levels of selected LPS gene targets were significantly high in DNP infants (6.17 ± 2.14 CFU/g) versus NDNN infants (4.13 ± 2.25 CFU/g), p = 0.003. So too was the abundance between DNP and DNN infants (p = 0.0023). The levels of selected LPS gene targets were high regardless of whether the infection was symptomatic or asymptomatic, p = 0.3808. The average expression of genes coding for selected LPS and their signalling molecule, Toll-like receptor 4 (TLR4), increased 7- and 2.5-fold, respectively, in DNP versus NDNN children. Infants possessing elevated levels of selected LPS-rich bacteria were 1.51 times more likely to develop norovirus diarrhea (95% CI: 1.14–2.01, p = 0.004). In conclusion, norovirus infection was associated with abundance of selected bacterial LPS, suggesting a possible role of bacterial LPS in norovirus infection. Full article
(This article belongs to the Special Issue Viruses Associated with Gastroenteritis)
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